Extensive calcification of cartilage in the region of the distal ulna and ulnar styloid process was caused by deposition of calcium pyrophosphate dihydrate crystals. More subtle calcifications appear in the periarticular soft tissues of the second and fifth metacarpophalangeal joints. Most of the interphalangeal joints exhibit evidence of degenerative arthritis.

Extensive calcification of cartilage in the region of the distal ulna and ulnar styloid process was caused by deposition of calcium pyrophosphate dihydrate crystals. More subtle calcifications appear in the periarticular soft tissues of the second and fifth metacarpophalangeal joints. Most of the interphalangeal joints exhibit evidence of degenerative arthritis.

Please read this document carefully before using the
ACR’s Rheumatology Image Bank. This is a legal agreement between you, the end user, and the
American College of Rheumatology (“ACR”). Your use of the Rheumatology Image Bank signifies your
acceptance of the terms of this License. If you do not agree to the terms of the License, you must not
proceed into the ACR’s Rheumatology Image Bank and you must return any images from the Image
Bank currently in your possession to ACR.

License: By this license, you are granted the right to use the Rheumatology Image Bank for
noncommercial educational, information and research purposes only. You are not granted a right to
use the Rheumatology Image Bank for the purpose of journalism, investigation, or reporting absent a
specific license granted by ACR. The images and associated captions of the Rheumatology Image Bank
may be copied and used for oral educational presentations delivered by you along with any supporting
documents needed for the presentation. ACR requests that you appose to images taken from the
Image Bank a notice of Copyright ownership to ACR in the form of “Copyright (year of creation of
presentation) ACR.” You may not use or share the Rheumatology Image Bank on a network, internet
or intranet without express written permission from the ACR. Images and associated captions may not
be incorporated in any work that is published, such as a journal, without express written permission
from the ACR. Permission requests can be sent to products@rheumatology.org.

Restrictions: The Rheumatology Image Bank is a proprietary, copyrighted work, derivative
work, and compilation of the ACR. You agree that you will not use the Rheumatology Image Bank, or
modify, rent, lease, sell, or create derivative works using the Rheumatology Image Bank. You agree
that you will not remove any notice of copyrights, trademark or other proprietary right from any place
where it is on or embedded in the content. If you have any reason to believe that images from the
Image Bank are attributed a wrongful ownership, you must report the discrepancy to ACR.

Terminations: A license is granted each time an image from the Image Bank is downloaded. The
license is specific to the Copyrighted work obtained from ACR. A license is effective until terminated or
until the natural expiration of the Copyright in the images downloaded from the Image Bank. The ACR
may terminate any License at any time in its sole discretion. In the case of termination of any license,
all Copyrighted materials or copies associated with this specific grant must be destroyed.

Disclaimer of Warranty on Rheumatology Image Bank and Data: You expressly acknowledge
and agree that use of this Rheumatology Image Bank is at your sole risk. THE RHEUMATOLOGY
IMAGE BANK IS PROVIDED “AS IS” AND WITHOUT ANY WARRANTY OF ANY KIND, INCLUDING ANY
IMPLIED WARRANTIES OF MERCHANTABILITY, SATISFACTION QUALITY, FITNESS FOR A PARTICULAR
PURPOSE, FREEDOM FROM INFRINGEMENT OR ORIGINALITY. No warranties are made that the
Rheumatology Image Bank will meet your requirements, or that the operation of this website will be
uninterrupted, virus free, or error free. No warranty is given as to the accuracy or reliability of the
data on the Rheumatology Image Bank.

Limits of Liability: ACR shall not be liable for any damages, including direct, indirect, digital,
incidental, special or consequential damages, or damages for loss of profits or revenues incurred by
you or any third party, whether in an action in contract or tort, arising out of the use or application by
you of the Rheumatology Image Bank or any component within.

Indemnification: You agree to indemnify and hold ACR harmless from and against any claims,
expenses, losses or liabilities (including professional fees and expenses) in connection with any claim
by a third party arising out of your use of any component of the Rheumatology Image Bank or the
application by you of the medical information contained by the Rheumatology Image Bank.

Transferability: The rights granted to you by ACR under this License of Agreement may not be
assigned, transferred, or licensed to any third party. ACR may transfer and/or assign at will this
License to any third party including any personal data associated with the ownership of the License.

Governing Law and Jurisdiction: This License will be governed by and construed in accordance
with the laws of the State of Illinois, without regard to conflict of law principles. All suits, proceedings,
or claims in connection with this License shall be brought in the courts of the State of Illinois in the
County of Cook and you hereby consent to the jurisdiction and venue of those courts. If any provision
of this License is held by a court of competent jurisdiction to be invalid, unreasonable, or
unenforceable, such provision or requirement will be enforced only to the extent that it is not invalid,
unreasonable, or otherwise unenforceable and all other provisions of this License shall remain in full
force and effect.

Comments, Suggestions or Questions: If you have comments, suggestions, or questions about
the contents of the Rheumatology Image Bank, contact: American College of Rheumatology; 2200
Lake Boulevard NE; Atlanta, GA 30319; Phone: (404) 633-3777; Fax: (404) 633-1870;
Email: products@rheumatology.org

TrademarkThe names, trademarks, service marks and logos of the
College appearing on this site may not be used in any advertising or publicity, or otherwise to indicate
the College's sponsorship of or affiliation with any product or service, without the College's prior
express written permission.

DisclaimersThe College is providing information and services on the
Internet as a benefit and service in furtherance of the College's mission. The College makes no
representations about the suitability of this information and these services for any purpose.

The College does not exert editorial control over materials that are posted by third
parties onto this site or materials that are e-mailed by third parties to any other persons. The College
is not responsible for any material posted by any third party. The College specifically disclaims any and
all liability for any claims or damages which may result from any postings by third parties. Although the
College site includes links providing direct access to other Internet sites, the College has not
participated in the development of those other sites, and does not exert any editorial or other control
over those other sites. The College accepts no responsibility for the opinions and information posted on
this site by users other than the College.

The College disclaims all warranties with regard to information posted on this site,
whether posted by the College or any third party; this disclaimer includes all implied warranties of
merchantability and fitness. In no event shall the College be liable for any special, indirect or
consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether
in an action of contract, negligence or other tortious action, arising out of or in connection with the use
or performance of any information posted on this site.

Do not post any defamatory, abusive, profane, threatening, offensive or illegal materials.